“Acquired” lobar emphysema: A complication of respiratory distress in premature infants

Cooney, Donald R.; Menke, James A.; Allen, James E.

doi:10.1016/0022-3468(77)90599-1

Cited by 37 publications

(18 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Relevant actions of dexamethasone upon lung inflammation and pulmonary mechanics are summarized in table 3. Dexamethasone was used as an alternative to the previously advocated strategies in the treatment of PIE with tension which include: lateral decubitus positioning [2,16], selective bronchial intubation [17,18] and surgery [16,19]. As demonstrated in the subgroup for whom there was a 'control' period, 3 days of dexamethasone therapy was associated with a 140% reduction in both the FiO 2 and MVI, whereas 2 days of conservative treatment resulted in no improvement in the amount of ventilatory support needed.…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone for Pulmonary Interstitial Emphysema in Preterm Infants

Fitzgerald

Willis²,

Usher³

et al. 1997

Neonatology

View full text Add to dashboard Cite

The efficacy of a 3-day course of dexamethasone (0.5 mg/kg/day) in 10 preterm infants (≤30 weeks gestation) with pulmonary interstitial emphysema (PIE) was studied in a retrospective case review. PIE was diagnosed at a median age of 7.5 days and treatment with dexamethasone began at 8.5 days. Seven of the 10 subjects had at least 2 days of conservative treatment (lowered mean airway pressure) preceding dexamethasone during which the mean airway pressure (MAP), oxygenation index (OI) and mechanical ventilation index (MVI) were not significantly different although within 3 days of dexamethasone each variable improved significantly (p < 0.05). Similarly, for all 10 infants, OI and MAP were significantly lower at 3 and 7 days from baseline (p < 0.005). By day 7, FiO₂ (p = 0.022) and MVI (p = 0.011) were significantly lower and PIE had resolved on chest X-ray in 7/9 (78%) and improved in the remaining 2/9 (22%). Nine of the 10 infants survived to term. Three days of dexamethasone was associated with significant clinical improvement in most of these infants. The mechanism may relate to reduced airway oedema and inflammation and reduced airway obstruction.

show abstract

Section: Discussionmentioning

confidence: 99%

Dexamethasone for Pulmonary Interstitial Emphysema in Preterm Infants

Fitzgerald

Willis²,

Usher³

et al. 1997

Neonatology

View full text Add to dashboard Cite

show abstract

“…It usually presents as respiratory distress in the first few days of life, and a majority of reported cases of congenital lobar emphysema have documented its presentation in neonates [1][2][3][4][5][6][7][8][9][10]. Approximately 50% of cases identified in the first month of life, and only 5% of cases are detected after the age of six months [11].…”

Section: Summary and Discussionmentioning

confidence: 99%

Congenital Lobar Emphysema in Adult Treated With Video Assisted Thoracoscopic Lobectomy

Perry¹,

Espiritu²,

Schroeder³

2013

J Pulm Respir Med

View full text Add to dashboard Cite

Congenital Lobar Emphysema (CLE) is an uncommon pulmonary disorder in which one or more pulmonary lobes is over-inflated and distended. Fewer than 5% of cases are diagnosed beyond the first 6 months of life. We describe CLE that presented in a 25 yr old female who was successfully treated with minimally invasive video assisted thoracoscopic surgery (VATS). Case ReportA 25-year old Puerto Rican female presented with increased shortness of breath, cough and chest pain. Her past medical history included diagnosis of asthma In Puerto-Rico at the age of five, treated with advair. During her third pregnancy, at the age of 23, the patient experienced shortness of breath and reported "fainting". A chest CT at that time diagnosed her with lobar emphysema.In the United States, she presented to an outside hospital with exacerbation of shortness of breath, where she was thought to have a pneumothorax, and a right chest tube was placed. She was then transferred to the Medical Center ICU. At presentation, She was afebrile, exhibiting tachycardia (117 bpm), with 28 respirations per minute, oxygen saturation of 91%, and decreased breath sounds on the right chest field.Pulmonary function test suggested of Restrictive Lung Disease (RLD) ( Table 1). The patient's initial X-rays, as seen in Figure 1, indicate hyperlucency on the right side, flattening of the right diaphragm, and a slight shift of mediastinum to the left. The right lung is collapsed inferiorly. There are a severe number of bullae within the right hemithorax, with some consolidation or collapse in the region of the right perihilar region.CT taken before surgery documented large bullae, mediastinal shift, and compressed right lung. (Figure 2 and 3). Treatment and Surgical FindingsSince the patient's shortness of breath was not successfully managed with Oxygen support and chest tube drainage, she was scheduled for a bronchoscopy and a Video Assisted Thoracoscopic Surgery (VATS) -right upper lobectomy. On BronchoscopyThe Right Upper Lobe (RUL) takeoff was a slit-like lumen, slightly distorted -confirms the diagnosis of CLE.VATS right upper lobectomy was performed with general endotracheal anesthesia with a double lumen tube and one lung ventilation. We used 3 ports; 10mm port in the seventh intercostal space in anterior axillary line, 10mm trocar in posterior axillary Using a 10 mm 30 degree Olympus scopeThe right upper lobe composed entirely of large bullae. The bullae did not deflate and were densely adherent to the chest wall. There were also aberrant blood vessels from the chest wall to the bullae, with no apparent superior pulmonary vein, pulmonary artery, or bronchi going to the bullous portion. However, the segmental bronchi and major pulmonary vessels were found attached to the area of the hilum of the atritic lobe. An endoscopic EndoGIA (Covidian) used to divide the vessels and the rudimentary bronchus. The lobe removed with an endobag. A 28 french chest tube was left in the chest. PathologyMicroscopic examination of the resected lobe showed dense fi...

show abstract

“…Fakat bizim olgumuz bu ileri tetkikleri kabul etmediği için yapamadık. Ayırıcı tanıda, pnömatosel, pnömotoraks, karşı akciğerde hipoplazi, diyafragma hernisi, konjenital adenomatoid malformasyon, yabancı cisim aspirasyonuna bağlı obstrüktif amfizem, mukus tıkaçları, endobronşiyal kitleler ve postinfeksiyöz lobar amfizem yer almaktadır (19,20). Ağır solunumsal semptomları olan infantlarda, morbiditeyi ve mortaliteyi önlemek amacıyla önerilen tedavi lobektomidir.…”

Section: Olguunclassified

Congenital Lobar Emphysema

Mutlu¹,

Guven²

2018

Respir Case Rep

View full text Add to dashboard Cite

ÖzetBir ya da birden fazla akciğer lobunun dışarıdan bir bası olmadan hiperinflasyonu konjenital lober amfizem olarak tanımlanır. 20.000 ila 30.000 doğumda bir izlenen çok nadir bir durumdur. Olguların %50'sinde etyoloji bilinmemektedir. Etyolojide suçlanan diğer nedenler, bronşiyal anormallikler ya da alveolar defektlerdir. Yetersiz kıkırdak desteğinin sonucunda bronşial kollapsın olduğu yönünde teoriler de vardır. Sıklıkla sol üst lob, ardından orta ve sağ üst loblar etkilenir, alt loblar ise nadiren etkilenir. Olguların %90'ı bebeklik döneminde ağır solunumsal semptomlarla tanı alır. Bu olgu sunumunda, erişkin yaşta tanı konan konjenital lober amfizem olgusundan bahsedilecektir.Anahtar Sözcükler: Konjenital, amfizem, hiperinflasyon. AbstractCongenital lobar emphysema is defined by hyperinflation of 1 or more lung lobes in the absence of extrinsic bronchial obstruction. It is a very rare condition with an incidence of 1 in 20,000 to 30,000 births. The etiology is unknown in 50% of cases. Other factors suspected in the etiology are bronchial abnormalities or alveolar defects. Some theories also include bronchial collapse as a result of insufficient cartilage support. The left upper lobe is frequently affected, followed by the middle and right upper lobes, while the lower lobes are rarely affected. Some 90% of cases are diagnosed in infancy with severe respiratory symptoms. In this report, a case of congenital lobar emphysema diagnosed in adulthood is described.

show abstract

“Acquired” lobar emphysema: A complication of respiratory distress in premature infants

Cited by 37 publications

References 13 publications

Dexamethasone for Pulmonary Interstitial Emphysema in Preterm Infants

Dexamethasone for Pulmonary Interstitial Emphysema in Preterm Infants

Congenital Lobar Emphysema in Adult Treated With Video Assisted Thoracoscopic Lobectomy

Congenital Lobar Emphysema

Contact Info

Product

Resources

About